Multivariate analysis of risk factors for hemorrhagic cystitis after hematopoietic stem cell transplantation

To establish the most appropriate prophylactic therapy and risk factors for predicting hemorrhagic cystitis (HC) after stem cell transplantation (SCT), we retrospectively analyzed the clinical records of 450 transplant patients treated from 1982 to 2002. In all, 81 patients developed early- and/or late-onset HC (early=29, late=48, both=4). For the incidence of early-onset HC, administration of cyclophosphamide (CY) (p=0.0079, odds ratio (OD)=5.109, 95% confidence interval (CI)=1.533-17.030), busulfan (BU) (p=0.0015, OD=3.336, 95% CI=1.584-7.027), BU+CY (p=0.0001, OD=4.369, 95% CI=2.055-9.292), antithymocyte globulin (p=0.0009, OD=3.368, 95% CI=1.642-6.911), nonradiation (p=0.0163, OD=2.564, 95% CI=0.181-0.841), 2-mercaptoethane sodium sulfonate (Mesna) (p=0.0001, OD=7.519, 95% CI=2.847-19.858), and bladder irrigation (p=0.0001, OD=4.950, 95% CI=2.328-10.523) were risk factors. By Fisher's exact test, the combination of BU and Mesna was a more significant risk factor (P<0.001) than Mesna alone (p=0.008) compared to the administration of neither agent. By multivariate analysis, prophylactic administration of Mesna (p=0.0105, OD=5.301, 95% CI=1.477-19.026) and bladder irrigation (p=0.0001, OD=9.469, 95% CI=3.872-23.156) were significant risk factors of early-onset HC. We conclude that (i). high-dose BU as well as CY is a cause of HC, (ii). protective bladder irrigation has an opposite effect, and (iii). Mesna possibly has a toxic effect on bladder mucosa.

[Secondary eosinophilia in a patient with hypereosinophilic syndrome after allogeneic bone marrow transplantation from a sibling donor]

A 23-year-old man first visited a local hospital in 1998 because of exertional dyspnea. Peripheral blood examination revealed mild leukocytosis with 82% eosinophils, and he was treated with prednisolone. As the eosinophilia did not improve, he was referred to Tokai University Hospital in March 1999 for further diagnosis and treatment. The patient was diagnosed as having hypereosinophilic syndrome (HES) because of unexplained hypereosinophilia persisting for more than 6 months, resulting in cardiac dysfunction. His disease was progressive in spite of immunosuppressive therapy, interferon-alpha and cytotoxic chemotherapy. Since he had an HLA-identical brother, allogeneic bone marrow transplantation (BMT) was performed in October 1999. After completion of the immunosuppressive therapy on day 79 after BMT, the number of eosinophils gradually increased again. Although we suspected recurrence of the disease, DNA fingerprinting revealed that the peripheral granulocytes were 100% donor type. An increase of interleukin-5 (IL-5) produced by peripheral lymphocytes and a decrease of the Th1/2 ratio suggested that the eosinophilia was related to GVHD. The eosinophilia was eventually controlled by cyclosporin. We conclude that DNA fingerprinting and examination of the IL-5 level and Th1/2 ratio are useful for differentiating between relapse and GVHD in cases of eosinophilia occurring after BMT for HES.

Determination of 18alpha-glycyrrhizin and 18beta-glycyrrhizin in dog plasma by high-performance liquid chromatography

A high-performance liquid chromatographic method has been developed for the separation and determination of 18alpha-glycyrrhizin (alpha-GZ) and 18beta-glycyrrhizin (beta-GZ) in dog plasma. The two compounds were separated on a reversed-phase column and detected by UV absorption at 254 nm. The mobile phase was a mixture of water-methanol-60% perchloric acid (45:55:0.5, v/v) and was adjusted to pH 8.0 with 25% ammonia solution. Indomethacin was added to the plasma as an internal standard. Methanol was selected for the extraction of both the compounds and internal standard. Alpha-GZ and beta-GZ could be precisely determined in concentration of 1 mg/ml in a 0.1 ml sample.

Results of a dental fear survey in Japan: implications for dental public health in Asia

The purpose of this investigation was to initiate the study of dental fear in Japan. 415 college students, aged 18-22 yr were surveyed. A standardized questionnaire which has been used in the United States was translated into Japanese and was administered to the students. More than 80% of those surveyed reported some dental fear. Six to 14% of the students reported extreme fear of the dentist. The majority of the subjects admitted that they delayed making dental appointments due to fear. Muscle tension was the most common physiological symptom reported. The dental drill and needle were the most fear-provoking stimuli.

[Application of PIXE (particle-induced x-ray emission) method to the cytolytic test of tumor cells]

Immunological studies have often been based on the results of cytolytic assay in which cells labelled with radioactive 51Cr are usually employed. The replacement of the radioactive isotope by a stable one is obviously desirable in order to eliminate the problem of radiation hazard and to prevent environmental contamination. We applied PIXE (particle induced X-ray emission) method for the detection of stable chromium (Cr). MM46 cells labelled with natural Cr were treated with anti-MM46 serum and a rabbit complement. The remaining Cr was filtered. The released Cr was precipitated with ethanol and deposited on the filter. The specimens were bombarded with proton beams from a Van de Graaff accelerator and the X-rays produced were detected with a Si(Li) detector. The Cr peaks appeared clearly. One of the main advantages of the application of the PIXE method is its high sensitivity. Another merit of the present method is that it can easily compare the remaining ratio of several elements in cellular materials after lytic treatment. This information may be used as a parameter indicating differences in the process of cytolysis.